Preview

Diabetes is a metabolic disease in which your blood glucose, or sugar, levels are too high. Glucose comes from the foods you eat. Insulin is a hormone that helps the glucose gets into your cells to give them energy.

With type 1 diabetes (Insulin dependent diabetes mellitus), your body does not make insulin. With type 2 diabetes (Non-Insulin dependent diabetes mellitus), your body does not make or use qualitative/ quantitativeinsulin well. Without enough insulin, the glucose stays in your blood. Type 2 diabetes is the most common form of diabetes. It is important to remember that there is no specific cure for diabetes; the condition can be controlled with regular exercise, proper diet and healthy lifestyle.

If the blood sugar levels cannot be maintained by the above changes the condition has to be controlled with appropriate medicines to regulate the sugar levels or by taking Insulin therapy.Uncontrolled Diabetes on long term can lead to complications. Family history and genes play a large role in type 2 diabetes. Low activity level, poor diet, and excess body weight around the waist increase your risk.(1)

Often, people with type 2 diabetes have no symptoms at first. They may not have symptoms for many years. It is not unusual for the diagnosis to be incidental when the patient visits the doctor for some other symptom and the blood tests reveal diabetes. Even routine health checkups detect diabetes at times.

The early symptoms of diabetes may include:

Bladder, kidney, skin, or other infections that are more frequent or heal slowly

Fatigue

Hunger

Increased thirst

Increased urination

The first symptom, which is not the usual presentation in majority, may also be:

Blurred vision

Erectile dysfunction

Pain or numbness in the feet or hands(1)

Self-care instructions:

Do's if you have Type 2 Diabetes Mellitus

Check your blood sugar level as advised by your doctor. Your doctor will help you set your blood sugar goals. Most people with type 2 diabetes only need to check their blood sugar once or twice a day.

Maintain a well-balanced healthy diet.

Keep your body weight under control.

Exercise regularly after consultation with your doctor.

Take medicines regularly as prescribed.

Pay special attention at your foot.

Don'ts if you have Type 2 Diabetes Mellitus

Do not neglect if you have any of the symptoms of diabetes mellitus or there are some family history of diabetes.

You could have eye problems, including trouble seeing (especially at night), and light sensitivity. You could become blind.

Your feet and skin can develop sores and infections. Such wounds could also be difficult to heal. Uncontrolled diabetes with poor compliance by patient can also result in conditions of non healing wounds and infections which could even result in removal of the diseased part. Infection can also cause pain and itching in other parts of the body.

Diabetes may make it harder to control your blood pressure and cholesterol. This can lead to a heart attack and other problems. It can become harder for blood to flow to your legs and feet.

Nerves in your body can get damaged, causing pain, tingling, and a loss of feeling.

Because of nerve damage, you could have problems digesting the food you eat. You could feel weakness or have trouble going to the bathroom. Nerve damage can make it harder for men to have an erection.

High blood sugar and other problems can lead to kidney damage. Uncontrolled diabetes with poor compliance by patient can also result in conditions of renal failure which could result in patient resorting to dialysis for detoxifying the body.

Infections of the skin, female genital tract, and urinary tract are also more common.(1)

Fig.2. Complications of Diabetes Mellitus Type 2.Photo Credit:http://www.myendohealth.com/Diabetes.html Preventing complications:To prevent problems from diabetes, visit your health care provider or diabetes educator at least four times a year. Talk about any problems you are having. Your doctor may prescribe medications or other treatments to reduce your chances of developing eye disease, kidney disease, and other conditions that are more common in people with diabetes. To prevent injury to your feet, wear proper footwear, check and care for your feet every day. You can help prevent type 2 diabetes complications by keeping a healthy body weight and an active lifestyle.

Check for hypoglycaemia. If any symptoms occur as shown below, eat some sugar or candy. Contact your doctor for change in medications or diet control.

Regular exercise is important for everyone. It is even more important you have diabetes. Exercise in which your heart beats faster and you breathe faster helps lower your blood sugar level without medication. It also burns extra calories and fat so you can manage your weight.Exercise can help your health by improving blood flow and blood pressure. Exercise also increases the body's energy level, lowers tension, and improves your ability to handle stress.

Ask your health care provider before starting any exercise program. People with type 2 diabetes must take special steps before, during, and after intense physical activity or exercise. Exercises for Type 2 Diabetes Mellitus

Move those muscles and Be Active.Research has shown that leaner and more active people are less likely to get diabetes (2). To find out your ideal weight and Body Mass Index (BMI) go to this link. Record your weight every day

Blood Glucose management

Hypoglycemia (wherein the blood glucose levels drop to dangerous levels) can result in catastrophic complications. To prevent this always keep a something to eat such as chocolate or sugar candy; also it is wise to let your near and dear ones and colleagues to know that you are diabetic so that they can help you in such episodes of hypoglycaemia. Please follow the link for more information on Hypoglycemia.
http://www.diabetes.co.uk/Diabetes-and-Hypoglycaemia.htmlKeep your blood sugar in constant check by maintaining a balanced diet and a prudent lifestyle. Keep a track of your blood sugar at home by monitoring it with glucometer at different intervals of the day.

Alcohol

Abstinence is the best policy. Oral hypoglycemic agents and alcohol can cause hypoglycemia.
Alcohol is high in calories, can increase blood pressure and blood sugar. If you drink, ask your doctor first.

Medication

Some of the medicines used for diabetes can have interactions with various medicines. Check with your doctor when you are taking any new medicines.

Tobacco and Smoking

Quit!Research suggests that tobacco use and smoking can make diabetes worse and may lead to other eye or kidney failures. Need help quitting, call - the National Tobacco Cessation Quit Line, 1800-22-77-87
To know more about the health benefits of quitting, go to

Stress Management

High stress levels may increase blood glucose levels. Incorporate a daily routine to relax and rejuvenate - try to listen to soothing music, chant, read a book or meditate.

Sleep

A sound night sleep is suggested to improve insulin use by the body. Exercise can help inducing sleep.

Caffeine

Reduce the intake of tea, coffee, colas and chocolate especially later in the day. Lowered caffeine intake is known to induce a better sleep during the night which in turn improves insulin use by the body.

Blood Pressure management

Maintaining a normal blood pressure of lower than 120/80 is important to lower the risk of further complications. Exercise can help to maintaining normal blood pressure

It is important to eat the right kind of food for a healthy mind and body. Diabetes Mellitus (Type 2) is a chronic metabolic disease where the body doesn't take up insulin properly which results in high blood sugar. It is recommended that people with diabetes should avoid fasting. Try to incorporate 6-7 small meals/snacks during the day.

Generally, all food items can be classified into six major groups (3) as shown in the Healthy Food Pyramid.(4)Immediate Diet Plan

Do's

Include lots of fresh, seasonal, local and if possible organic Fruits and Vegetables.

Slash down any intake of carbonated, caffeinated or alcoholic beverages.

Curb your Salt intake, as sodium in the salt has to tendency to retain water in the body which can increase blood pressure and add other complications. Do not add salt while cooking and restrict consumption of packaged food. (5)

Sample Diet PlanBelow is a sample Diet Plan for a patient who is diabetic (type 2). Make sure to check the correct portion/serving sizes for each food item by going to these links.(6), (7)Refrain from fasting and talk to your doctor or dietician about any restrictions on fluid or water intake. Do not add SALT or SUGARwhile cooking or as seasoning. For cooking, try to use either Olive oil or peanut oil.

MEALS

FOOD TYPES

WEST (MAHARASHTRA)

Early morning

- 1/4 serving of milk products
- 1/2 serving of cereals

- 1 cup of tea/coffee or buttermilk
- 2 Marie biscuits or 1/2 of a chapati(15g)